Patient monitoring outside the hospital has been a hot topic (and also a not so hot topic) for the past 15 years.
Starting back in the late 1990s with companies like Health Hero Network, a company whose products for patient home monitoring are still in use today, company after company has sought to bring a successful product to market. The holy grail: finding an easy, non-intrusive, and continuously reliable way to predict patients’ potentially serious medical problems when it is early enough to do something about them and prevent an acute and expensive episode of illness. Some of the newer companies are focused more on the wellness and tracking side of the equation, such as helping individuals see progress from an exercise or other preventive/health-inducing regimen.
So far this whole area has been a very tough nut for businesses to crack in the US in particular. While some studies have shown great positive effect, others have not. Insurance payment for these programs has been spotty at best and non-existent at worst; most of the current vendors are stuck in pilot hell without significant long term and widespread commitments from payers. There is a belief, veracity unknown as yet, that the proliferation of risk-based entities such as Accountable Care Organizations will change this and lead to broad adoption of ambulatory patient monitoring tools, angels will sing and a large number of hospitalizations and rehospitalizations will be avoided. That may be true, but remains to be seen.
Not through a musical hook or melody that you can’t shake. Or a well timed smile by someone your soul connects with. Or a box of chocolates. Or a poem. People have been penetrating the human heart with those Luddite-ish tools since the beginning of civilization.
I was thinking more about that electronic device your doctor might have implanted into your chest to keep your heart beating. Or the little box stuck in your gut to help you and your pancreas regulate your diabetes. Or the mini-computer surgically inserted to keep your neurological systems on track.
Hacking the medical miracles put inside people to let them live longer with more normal lives.
While to my limited knowledge nobody has reported a single case and the likelihood is extremely low, it is a real enough concern that the New England Journal of Medicine published a paper about the need to improve security last year.
As a journalist who for the last decade has covered the use of information technology in health care, I’m rather disgusted at some of my brethren in the mass media. I’m none too happy with the medical establishment, either. Both seem hopelessly stuck in the past, refusing to look beyond the status quo. And the public suffers because of it.
This fall, for example, the Los Angeles Times and other news outlets covered a Yale University study that sought to determine whether or not “telemonitoring” heart failure patients recently discharged from the hospital would reduce heart attacks or readmission. The study, published in the New England Journal of Medicine and presented at a November meeting of the American Heath Association, concluded that that telemonitoring, which involved patients calling in their weight measurements and health symptoms after being discharged, made virtually no difference in the outcome. The Times called the trial “a good, commonsense idea that simply didn’t work out.”
Was it, really?
Keeping in touch with one’s physician on a frequent basis after being hospitalized for heart failure is a fine idea, as is monitoring one’s weight. But, as happened in the Yale study, patients generally don’t stick with the program. One in seven study participants never called their doctors, while just 55 percent of patients were making at least three calls per week six months after discharge.Continue reading…